Northwest American Indians are a drastically understudied and underserved group, at ilsk for multiple health problems induding poor maternal health during and after pregnancy. American Indians living in the Northwest have very high rates of poor maternal and irtfant outcomes. This application, in response to RFA HHS-2009-HIS-NARCHV-O001, involves a 4-year developmental project to explore matemal health behaviors, maternal substance use, risk factors for substance use during and after pregnancy, and protective factors that support healthy matemal behaviors. Findings will assist the research team in designing a culturally appropriate and feasible intervention program for American Indian mothers living in the Northwest. Building upon existing preliminary epidemiological and surveillance data as well as tribal support, this study proposes five innovative and significant aims. First, we will conduct qualitative formative research involving 4 focus groups and 25 key infomiant interviews with mothers aged 18-55, Native health providers, elder/traditional healers, and Native youth (aged 15-25). Second, we will conduct structured survey interviews with 100 American Indian community members. With these inten/iew data, we will establish preliminary baseline data related to matemal health outcomes, protective health tjehaviors, risk factors for substance use during and after pregnancy, and social support for mothers. Third, we will develop and manualize a culturally-based intervention targeting adult American Indian mothers in the Northwest. Fourth, we will translate and disseminate the findings to the tribe and prepare translational materials for community members and service providers. Fifth, throughout the course ofthe study, we will work to expand the research infrastructure at Lummi Tribal Health Clinic and to increase research capacity in the tribal community. PERFORMANCE SITE(S) (organizafion, city, state) University of Washington Office of Sponsored Programs, 1100 NE 45*''Street, Suite 300, Seattle, WA. 98105 University of Washington, Seattle, WA Indigenous Wellness Research Institute, School of Social Woric, 4101 15* Ave. NE, Seattle, WA. 9810p The Lummi Tribal Healtb Health Clinic, Lummi Reservation, Bellingham, WA PHS 398 (Rev. 09/04) Page 2 Foiw Page 2 342 Principal Investigator/Program Director (Last, First Middle): Evans-Campbell, Teresa (Project #3) KEY PERSONNEL. See instmctions. Use continuation pages as neededto provide the required information in the format shovm below, start with Principal Investigator. List all other key personnel in alphabetical order, last name first. Name eFM Commons User Name Organization Role on Project Teresa Evans-Campbell TECAMP University of Washington Principallnvestigator Antony Stately STATELY University of Washington Co-Investigator OTHER SIGNIFICANT CONTRIBUTORS Name Organization Role on Project Karina Walters University of Washington Consultant Bonnie Duran University of Washington Consultant IHuman Embryoitic Stem Cells Q No [H Yes If the proposed pro|ect involves human embiyonic stem cells, Ilst below the registration number of tiie specific cell llna(s) from the following list httP://StemceilS.nih.gov/reQiStn//index.asP. Use continuation pages as needed. If a specilic line cannot be referenced at this time, include a statement that one firom the Registry will be used. Cell Line Disclosure Permission Statement Applicable to SBIR/STTR Only. See SBIR/STTR instructions. . D YeS I3 No PHS 398 (Rev. 09/04) Page 3 Form Page 2-contlnued Number the foitaming pages consecutively throughout the application. Do not use suffixes sucti as 4a, 4b. 343 Prindpal Investigator/Program Director (Last. First, Middle): Evans-Campbell, Teresa (project #3} Project Narrative The Northwest Washington Indian Health Board recently identified maternal health and substance use as one of its highest priority concems for AIAN women in the Northwest. AIAN women suffer from high rates of poor matemal health indices and experience dramatic health disparities related to matemal health care access. The proposed research will contribute to the public health by assisting in greater understanding of factors related to matemal health and wellbeing and the development of an intervention to support matemal health and decrease matemal substance use. 344 Program Dtrectofffftncipal Investigator (Last Firet Midtfe). EvanS-Campl)ell, Teresa (project #3) The name ofthe program ifirector/tvfrKipal bwestigator must be provided at the top of each printed page and each continuation page. RESEARCH GRANT TABLE OF CONTENTS Page Numbers Face Page 3^ Of Description, Project/Perfonnance Sites, Senior/Key Personnel, Other Significant Contributors, and Human Embryonic Stem Cells ._ -^ 391. Table of Contents ^ .. JS'^lp Detailed Budget for Initial Budget Period .. 5 V^ Budget for Entire Proposed Period of Support 3 W? Budgets Pertaining to Consortium/Contractual Arrangements . .".. -^-. Biographical Sketch - Program Director/Pfincipal Investigator {Ndto exceed foir pages each) QS"'/ Ottier Biographical Sketches (Not to exceed four pages each - See in^rudions) 3^^ Checklist , " 1^5? Research Plan., Introduction to Resubmission Application, if appBcable (Not to exceed three pages.), at Introduction to Revision Application, if applicable (Not to exceed one page.);. 357 Specific Alms rsy [unreadable]-" .^Sf 3. Background and S^nWcance L^ ....J 36/ 45. RPresliemairncahryDSestuigdnieasn/PdroMgertehsosdRs eport [unreadable]J^p..*".(Items 2-5: nottto exceed 25 pages) T!^ LsO^^ C" 6. Inclusion Enrollment Report (Renewal or Revision applications only) ^^ 7. Bibliography and References caed/Progress Report Pubdcadaii Ust 3^1 8. Protection of Human Subjeds . 3^^ 9. Inclusion ofWomen and Minorities ~...., _ _...." 07/ 10. Targ^ed/Planned Enrollment Table _ - 3^)1^ 11. Inclusion of Children _ : _ " ^^3 12. Vertebrate Animals.'. _ ~ " -*' 13. Sdect Agent Research ".._ _ _ " _ 14. Multiple PD/PI Leadership Plan " :.,. _ _-- [unreadable] 15. Consortium/Contractual Anangements 16. Letters of Support (e.g.. Consultants).- 2^ 17. Resource Sharing Plan (s) _ _ _ _;_.._ "^ ' Appendix (Five identical CDs.) I I Check if I ] Appendix is Included: PHS 398 (Rev. 11/07) Page Form Page 3 345